Key result
Epirubicin linked to ~11-fold higher cardiotoxicity risk among anthracyclines in acute myeloid leukemia.
Why the study?
Anthracyclines are key for treating acute myeloid leukemia but carry serious side effects, prompting an evaluation of their adverse effects across different drugs and patient populations.
What are the distinct adverse event profiles and time-to-onset patterns of different anthracyclines used in acute myeloid leukemia treatment?
Observational (n=1,079)
What are the distinct adverse event profiles and time-to-onset patterns of different anthracyclines used in acute myeloid leukemia treatment?
Odds Ratio: 2.56 (95% CI 2.26–2.9)
Different anthracyclines exhibit distinct safety profiles in AML patients, with epirubicin and doxorubicin showing strong cardiotoxicity signals, highlighting the need for individualized, agent-specific monitoring.
Alerts clinicians to anthracycline-specific risks in AML; leaves open need for prospective validation before practice change.
Background Anthracyclines are key for acute myeloid leukemia (AML) but carry serious side effects. This study identifies their side effects across drugs and patient populations using the FDA Adverse Event Reporting System (FAERS). Materials and methods We analyzed 1,079 AML cases and 3,622 adverse events (AEs) from FAERS (2004–2024). Disproportionality analyses (PRR, ROR, BCPNN, MGPS) detected AE signals; Kruskal–Wallis tests evaluated time-to-onset by age/sex. Results Distinct risks emerged: epirubicin (strongest cardiotoxicity, ROR = 10.57), doxorubicin (highest pregnancy-related AEs, ROR = 9.97), daunorubicin (vascular disorders, ROR = 2.38), idarubicin (myelosuppression/infections). Most AEs occurred within 180 days. Idarubicin showed delayed onset in elderly (P < 0.05); males had delayed doxorubicin toxicity (P = 0.04) but accelerated idarubicin onset (P = 0.049) vs. females. Conclusion This analysis identifies distinct safety profiles. Epirubicin and doxorubicin were associated with cardiac and pregnancy-related risks, while idarubicin showed signals suggesting potentially delayed onset in elderly patients. Observed sex differences indicate possible variations in AE patterns.
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Wang et al. (2026) conducted an observational in Acute myeloid leukemia (n=1,079). Anthracyclines vs. Background adverse event reporting in FAERS was evaluated on Cardiac disorders adverse event reporting (ROR 2.56, 95% CI 2.26-2.9). Anthracyclines demonstrated distinct safety profiles in acute myeloid leukemia patients, with epirubicin showing the strongest cardiotoxicity signal (ROR 10.57) and doxorubicin showing high pregnancy-related risks.
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